Individual provider Active NPI

Nelson Bayron, MSW

  • Clinical Social Worker
  • Plantsville, CT
National Provider Identifier
1477616100
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
000416 Issued in CT
Practice address
790 S Main St
Plantsville, CT 06479-1555
Phone
(860) 621-8093
Fax
(860) 628-9801
NPI assigned
Dec 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 000416 CT Primary

Addresses

Primary practice location

790 S Main St
Plantsville, CT 06479-1555

Mailing address

790 S Main St
Plantsville, CT 06479-1555
Phone (860) 621-8093

Other identifiers 3

IdentifierTypeStateIssuer
C009024OtherCTTRICARE
140000416CT01OtherCTANTHEM BEHAVIORAL HEALTH
0004212003OtherCTAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120416000625 CT Practitioner - Clinical Social Worker 1153582374 Practice locations: Plantsville, CT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

790 S Main St
Plantsville, CT 06479-1555
Phone (860) 621-8093

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
416CTMDBehavioral Analyst
000416CTMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477616100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 S MAIN ST",
            "city": "PLANTSVILLE",
            "state": "CT",
            "postal_code": "064791555",
            "telephone_number": "860-621-8093",
            "fax_number": "860-628-9801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 S MAIN ST",
            "city": "PLANTSVILLE",
            "state": "CT",
            "postal_code": "064791555",
            "telephone_number": "860-621-8093",
            "fax_number": "860-628-9801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAYRON",
        "first_name": "NELSON",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "000416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "C009024",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BEHAVIORAL HEALTH",
            "identifier": "140000416CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0004212003",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantsville, CT

Sources for this page

Verify at the official NPI Registry.